The Infectious Diseases We Don’t Seem to Care About

CG original research released this week clarifies the extent to which the distribution of childhood vaccines worldwide (polio, measles, pertussis, etc.) was interrupted by pandemic restrictions – and this outcome is illustrative of how detached from reality, rationality, and morality our response measures have become.

We created – and often failed to correct – a situation in which we cancelled life-saving vaccines to children worldwide because of restrictions intended to protect the elderly and health care systems. More recently (and confoundingly), medical and governmental authorities have begun to emphasise the importance of vaccinating young, healthy children against COVID-19, even though young, healthy children are at very low risk from COVID-19.

This discordance highlights the intergenerational unfairness pandemic restrictions created. It is also an example of the double standard we adopt unquestioningly when addressing infectious diseases in wealthy countries vs developing countries.

It is a sign of our detachment from proper moral thinking because, once again, we have allowed ourselves to be placated with moralising mantras like ‘We are all in this together’ while inarguably disregarding the interests of a substantial (and precious) portion of that “We”: Children.

Our myopic focus on COVID-19 caused us to ignore that, especially to children, other vaccine-preventable infectious diseases pose a threat comparable to that which COVID-19 poses to the elderly. Children, especially in low-income countries (and indeed everywhere), are constantly under similar deadly threats from infectious diseases pre-dating COVID-19. For example, in Western Europe, measles causes death in about 1 in 5000 cases, but as many as 1 in 100 will die in the world’s poorest regions. This is a significantly higher mortality rate than that of COVID-19 in the vast majority of the population. And yet, disruptions in supplies of the MMR vaccine is one of the costs of pandemic restrictions that this week’s report brought to light. 

Over the past year, global leadership decided that increasing that threat for children was an acceptable cost of pandemic response measures – or, in the most generous interpretation – neglected to consider the possibility.  All this while promoting rhetorically-placating-but-essentially-empty messaging that ‘we are all in this together. And this is yet another example of how morality has given way to moralism. If we honestly believed that we were all in it together, we would have preserved children’s protection from vaccine-preventable infectious diseases that kill them.

There is no moral calculus that concludes that protecting the elderly from COVID-19 through restrictions – even assuming lockdowns work – is more important than protecting the young from measles. The miscalculation is even more apparent when we acknowledge that, unlike lockdowns and other restrictions, a vaccine like MMR is a cost-effective, evidence-based, and safe way to protect those at risk.

Children and young people have probably been the primary victims of the collateral damage of pandemic restrictions. They have been used as mere means to protect the elderly when we closed schools and isolated them from their peers. They are now being asked to take a vaccine against COVID-19 from which they benefit very little, and indeed whose risk profile is not well defined. All this, while many of them have been deprived of more important vaccines that could make a difference between life and death, simply because we decided that closing down our society was more important.

Thus, the disruptions in vaccine distributions and coverage we report this week exemplify how our pandemic response measures are detached from reality. We have failed to put the risks of COVID-19 and those of other infectious diseases in the appropriate perspective.

To be more specific, it is a sign of our detachment from proper moral thinking because, once again, we have allowed ourselves to be placated with moralising mantras – ‘We are all in this together’- while inarguably disregarding the needs and interests of a significant (and most precious) portion of that “We”: children.

Alberto Giubilini is a philosopher and Senior Research Fellow in practical ethics at the University of Oxford, specializing in public health ethics and the ethics of vaccination. He is also a member of the CG Editorial Board.

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